Tuesday, 29 October 2019

Fuck Off Falciparum

Just an update on the health situation.

Felt a bit better for a couple of days, so dragged myself along to Kigali Black Food Festival. It's an international festival celebrating food that is coloured black, so basically the antithesis of unicorn food. Very little this unusual happens in Kigali, so I really wanted to go have a look.

It wasn't easy to find. They held it at Serena, which is a huge hotel in town, but nobody thought to put up a sign and none of the staff at reception seemed to have any idea there was an event going on. Just a load of lost people wandering around the car park looking for food. I was about to go home when I heard music and followed it to the very far side of the car park where there was a giant marquee. Even when I approached and asked the guy on the door, 'Is this the food festival?' He shrugged and told me to go to reception... Serena has a little way to go on event management.

I took a risk and went inside. It was the food festival. Instantly bumped into five people I know - which is the way of things in Kigali. Managed to get a picture in the live feed. 

L-R: Anysie, Leah and me.

Turned out to be more of a craft fair than a black food fair. There were some black samosas and someone had coloured the hot dog buns with beetroot, but mostly it was clothes, jewelry and cosmetics. Nice enough for a look round, though. I bought jollof rice and some exquisite peanut brittle from a Ghanaian lady who has lived here for the past couple of years.

Jollof Rice

Also bought some West African black soap. Both the soap and the jollof rice are things I was introduced to in Sierra Leone in 2008. Things you don't commonly see in Rwanda. Bought a few other things including an evil eye charm to hang over the door and a hot dog. Appetite was starting to return.

Black Soap

Only stayed about an hour, got home pretty exhausted but extremely happy I'd been on an outing and brought home some yummy food. Ate, watched Bojack Horseman, went to bed early.

Next day, still feeling fairly okay. Pottered about, washed some clothes. Started writing a contract bid. Got to the last paragraph - aches. Real bad aches. Swiftly followed by tears and shivers. I lay on the couch in a complete state and knew, one-hundred percent, this wasn't in my head. But lay there a long time because I was worried that if I went to the clinic and all the tests came back negative again, I wouldn't be able to take it. Thought it might just be better to lie there and let it pass without the discomfort of moving too much. 

Then the shivers started to sooth as my temperature bumped up and I thought, time to make a decision.

Talked myself through everything, out loud: get bag, wallet in bag?, get clothes, wrap up warm, get keys, take phone...

Left with three layers on and still felt like the Arctic all the way to the clinic. Had to go via an ATM machine and could hardly get the card in the slot I was shaking so hard. I love the Polyclinique du Plateau, but I wish so much that they'd get a card machine. They still do everything by cash and that's tough when you're sick and need emergency treatment.

Anyway, turned up sobbing as usual, was ushered into a side room, then a private bed. Again, the doctor was great. This time didn't ask a single question about my mental health, just took blood samples and got the nurse to jab me in the bum with a soothing dose of diclofenac. When I was able, I headed to the bathroom for another urine test. Then I closed my eyes and tried to sleep for a while until the results came back.

When the doctor walked into the room, I was really bracing myself. 

"Everything negative?" I asked.

"No," he replied. "You have malaria."

I burst into sobs all over again, but this time it was utter relief. 

I was fairly certain it was that quite early on, but when the tests kept coming back negative, I believed them. Now we had a name for what was happening and a course of action. I couldn't stop thanking him. 

They gave me an injection of something to help protect my stomach, because coartem is really harsh on the tummy, plus the antibiotics hadn't cleared up the UTI so I needed a seven-day dose of a different brand, and to top it off, I'd also developed tonsillitis. My immune system was wiped by the malaria.


Still, I must have been the happiest person on the planet to get it. Or at least to know I had it. The not knowing was hideous. I felt like I was starring in my own personal remake of Gaslight. Starting to question my sanity, wondering if it was all in my head. At least now I can cry like a child, safe in the knowledge I'm not losing my mind. 

I finish my last dose of coartem tomorrow morning. Due to it being very late when I got home from the clinic, and that you're suppose to take the second dose eight hours after the first, then every twelve hours after that, I unfortunately have to wake at 6 a.m. to take my morning dose with milk. I usually find it tough to get back to sleep after that, so I'm pretty tired right now, and sleeping a lot in the afternoons, but the aches have almost gone and the waterworks are under control. Fingers crossed, this is an end to it. 

It's now a case of building my strength back up and trying to repair some of the torture I put my body through with all the artemether, antibiotics and painkillers. It's been rough. Starting out with two large tubs of the most incredible locally-made natural Greek yoghurt from Casakeza. Delightful to eat and full of good bacteria.

In a bit of really lovely news, I took delivery of some beautiful art the other day. I did a favour for a friend and stored some of her stuff for a couple of years whilst she was away. In return, she asked her artist friend Rukundo to help transform the bass strings of my old Lirika piano into a giant treble clef. It was really emotional taking the strings off the piano. We took it apart to see if we could replicate it through the Kigali Keys project, and I knew I didn't want to throw them away. I had the idea of a treble clef, but nothing prepared me for what Rukundo came up with. It's incredible. A real statement piece that looks fabulous on my wall. Emmy came to drop it off, and it's as tall as he is!

Fingers crossed that by the next time I post, I'll be well on my way to recovery. Already doing much better, and I've been overwhelmed by the love and support of my friends. So many kind messages and hugs. Really got me through.

I will leave you with a scene from Rwanda's wet season. We've been having lots and lots of rain.

Friday, 25 October 2019

Crash and Burn

This is Sam's friend who visits every day to smack her head against the window. That's a pretty fit analogy for the past week, which has been one of the toughest in a very long time. Currently having an awful time of it. This is going to be a long, therapeutic unload.

And it's worse, because it started in such a lovely place. Ice-cream-and-apple-pie-on-the-beach lovely.

Did some editing by the water's edge whilst Sam was at work. Admired the wildlife.

Hadadas, so named because they make an insanely loud hadada hadada call.
Technically an ibis.

(panoramic, click to enlarge)

So, things on the plantation were going well. Until they weren't.

Had such a lovely night out a week last Tuesday at Serena. Really nice meal, snuggley and happy.

Woke up the next day to a phone call from the vet, saying they'd lost Gizmo. Literally, not euphemistically. The vet arrived in the morning to find his cage open. The door to an adjoining bathroom was also open, and the mosquito netting around the window was torn. So, looks like he made an escape. I'd dropped him off there before going to Gisenyi because he had an infected wound on his leg that just wasn't clearing. He was fighting me when I tried to tend to it, so I thought I'd leave him with the professionals whilst I was away for a few days and pick him up on the way back.

Not to be.

If you live in Rwanda, please take a photo of this picture and WhatsApp to anyone you know in the Niboye area of Kicukiro. Extra points for reaching local security guards.

Well, fuck, I thought. What a couple of weeks:

  1. Malaria
  2. Car crash
  3. Lost my cat

Not great, but I was feeling pragmatic about it. Couldn't get mad at the vet because she's a friend and was also distraught about it. Nothing like this has ever happened there before. Trust Gizmo to be the first.

Over breakfast, I started a discussion about when I should head back to Kigali. Sam was leaving for India for a month and I thought he might need a couple of days undistracted to pack. Agreed the next day would be okay.

And that's when the trouble started. I began to have big, dark thoughts. This world of sadness descended and continued to build. By the time he came back for lunch, I was sobbing uncontrollably. Absolute mess and incapable of saying why.

And yes, I know, malaria, car crash, cat - I know. But this was out of the ball park, and the thoughts I was having were all about fears for the future and personal insecurities. Wasn't having flashbacks to the crash or thinking about my cat. It was a full-on depressive meltdown.

Think Sam was a little bit stunned by this, and headed back to work with the suggestion of watching a movie later.

At which point, I did something monumentally silly.

I packed my bags, walked out of the gate and hailed the next bus back to Kigali.

When I feel extremely sick or extremely drunk, I have a homing instinct that would put most pigeons to shame. I just get up and walk out of places. I have to be on the move. Sitting on a bus is one of the most cathartic things when you're emotionally fucked, because you're surrounded by people but no one asks you to explain anything. You can just sit there and watch the world go past.

By the time I reached Kigali, it was dark and I didn't feel any better, but I needed to be in my own bed, in my own house, alone. Still, I really should have told him I was going and not put my phone on aeroplane mode. That was undeniably shitty, but I was in no state to cope.

Except for one brief trip to the vet on a futile search for Gizmo, I spent the next four days in bed sobbing my heart out and aching like a fucker. By the time I realised it wasn't going to stop, it was the weekend, and the International Clinic isn't open on weekends, so I had to wait until Monday. I didn't feel too certain about going to my local doctor in such an emotional state, because I wasn't sure how they would view a tearful mzungu. Traditionally, you're not supposed to cry, and I've felt bad in the past undergoing burn treatment when I've cried loud enough for people to hear. A lot has changed over the past few years, but I thought perhaps I'd fair better at the Belgian Embassy. It's the go-to for many expats.

So, round one. International Clinic, Monday morning.

I turned up hardly able to string a sentence together, I was crying so much.

The doctor checked my blood pressure, heart rate and glands, and took some blood samples for overnight analysis. I did say, 'I'm not sure if I need a head doctor or a body doctor,' and when she learned I had a history of mental health in my youth, she told me to go straight to counselling.

I went home, e-mailed my friend (who runs the counselling centre) and enquired, but decided to hold off for the blood tests.

That night, I had a fever of 38.1, and extreme shivers and aches. Didn't get to sleep until 4 a.m., with the aid of paracetamol. I'd had aches before - like flu - but until then I was still managing a full eight hours' sleep. But I'd always wake in the morning and within two minutes be soul-tired and crying again.

The next morning, I texted the doctor to tell her about the fever and shivers, but she said the blood tests all came back clear and to give it a few days and go talk to somebody.

Wasn't certain about that. Absolutely I was depressed, but that felt like a symptom, not a cause. I know the mind can affect the body, but vice versa, and I really wanted to rule out everything else before parting with 30k to sit on a couch. Decided to drag myself to my local clinic. Which, turns out, is where I should have gone in the first place. I like it there, they know me, it's always very efficient, and the doctor was amazing.

The first clinic hadn't told me what they were testing for, and just told me 'everything came back clear.' This doctor (who I also sobbed at for the first few minutes), decided to run every test they had. From pregnancy and STDs through to blood sugar and malaria.

He also asked a lot of questions about my day-to-day life, stress levels and even my dreams - which was a new one. Pretty clued in to mental health. Quite impressed by that. But no, I don't have nightmares or anxiety dreams, I sleep well most nights, I seriously miss my cat but my friend Emmy took me driving around for an hour handing out flyers to local bars, and I wasn't crying then. I cry when I wake up in the morning and when I ache. And I ache a lot. And it comes on so suddenly, and goes on for so long. I've lived overseas a while now, had my ups and downs, but this isn't normal.

Went back in the afternoon for the results.

Again, the doctor was great. Sat down and went through all the results with me, explaining everything. Not pregnant, no STDs (always nice to know), no malaria, but I had an infection and a fasting blood sugar level of 125, which is apparently one point off diabetic.

We went over and over whether I had eaten anything that morning, and I hadn't.

I texted to ask the International Clinic what my blood sugar had been the day before, because I also hadn't eaten then, but they hadn't taken a blood sugar test so no previous data to go on. They also hadn't taken a urine test - which is how they caught the infection.

Must admit, felt a little annoyed at that point. When you've had a history of mental health problems, however long ago, it can be extremely stressful to have that brought up as the go-to issue. Like you have to prove your sanity before you're taken seriously about physical pain, in ways people who walk in without that history probably don't have to do. I can understand why, from the doctor's perspective - vital statistics seemed normal, blood tests seemed normal, patient bawling her eyes out. Case closed.

But, realistically, you can't talk away an infection or hyperglycemia, no matter how good the therapist.

Fully willing to admit that the meltdown was an accumulation of everything: malaria, crash, cat, fella leaving for a month, but not willing to admit that's the conclusive reason for the physical pain I'm in. No doubt massively added to the stress, and stress crying is a thing for me, but not at all convinced this is all in my head.

The second doctor was pretty alarmed by the sugar results, and drew me a helpful chart showing how I should be eating. 

So incredibly sweet, and if I was eating, I'd have given it a go. Easier to achieve in Rwanda with melange, which is basically a buffet containing all of these ingredients, so you could happily load your plate like that.

He gave me antibiotics for the infection and some kick-ass painkillers and told me to come back for another blood test the next day.

Oh, my gods, what amazing painkillers. I swear, within twenty minutes of dropping them, I was giggling like a lunatic. Just to have that break from the aches. And my lovely friend Maia called to talk for forty minutes whilst walking home down Oxford Street. I was in tears all over again because she was so supportive. I owe my sanity to my friends: Harris, Solvejg, Dara and Jo. They all have infinite patience and kindness. Maia was the first to get me properly laughing again. No judgement, listened to everything that had happened, even the bits I wasn't proud of, believed me when I said it was physical, and just made it all seem a lot smaller.

Back to the clinic the next day...

Human Pin Cushion

Aiming for a sugar level below 100, got 104. Score. First day I wasn't weeping, so felt like the painkillers and antibiotics were kicking in. Continuing with that course at the moment. Still occasions when my back and chest are killing me, but emotions are a little more stable. Apparently infections and inflammation can trigger mood disorders. Just feeling believed and listened to made a huge difference. Feels like I'm taking some affirmative action.

See what happens in another three days when the meds run out.

Also, my adorable friend, Harris, gets back in a few days. He's a doctor and knows me really well, so hopefully he can offer some advice if it hasn't cleared up.

Slightly worrying.
Both the antibiotics and the painkillers look pretty similar.


I left off there to go spend an hour looking for Gizmo. Couldn't find him. If it was any of the others, they would come running up to greet me, but Gizmo is such a shy little boy. If there's anyone in the compound, he hides and won't move until they've gone. Hopefully, that means he's still around the vet's somewhere, but I'm only guessing.

Got home. Ate. Aches kicked in like a fucking bastard (swearing helps reduce pain). Harris called when I was in the middle of a full-on sobbing session. Continued for about an hour after the call, accompanied by extreme shivers. I was already on the good painkillers, but they weren't working. Then temperature bumped up and I was warm again. Heat soothes the pain. I'd rather have a fever than chills any time.

Totally exhausted, going to bed.

It's just the continuous pain. If I knew it was flu or malaria and had some idea how long it might last, I think I'd cope better. Thought the antibiotics would have really killed it by now, but still a couple more days to go. Going to ride it out and then see where we're at once they're finished.

Harris will be here really soon and I'll be in good hands. At this point, I want to try everything to see if anything helps, so it's really good to have a medical professional on hand to say, "Uh, that's not a good idea." Pain can drive you crazy.


So, that's been the shit side of things. And it has been pretty shit.

Also not sure if I still have a relationship at the moment. Walking off like that was crappy, and he was hurt. We've exchanged a call and a couple of messages since, but who knows. A month is a long time. I'm just going to focus on feeling well right now. The rest can wait.

Despite all of this doom and gloom, there have been some really nice things happening, too.

Between test results, I managed to hall myself to lunch with someone I've wanted to meet for a really long time. She's a bit of a living legend in Kigali, having developed tourist maps for Kigali, Kampala and Nairobi. She also runs a social media community and website for Kigalians, which I've been helping to moderate for about a year now. 

Before her Facebook group there was one called Expats in Rwanda. A while back they decided to have a clear out of their membership to remove all Rwandans and only make it about expats, but in doing so, they removed a lot of African members who came from places like Uganda and Kenya, and were legitimately expats in Rwanda. Seemed extremely racist, so a lot of us - including me - left. She set up her group as an inclusive place for all  people living in Kigali, so I like it much more. It's now got over 8,600 members, which is a huge achievement.

She lived here for a really long time, but now she's based in Canada, so although we've exchanged the occasional e-mail, we'd never met.

Went to Kiseki, where I managed to eat everything on the right-hand side of the plate. Major step forward. Ironically, an all-you-can-eat buffet, and that was all I could eat.

Just talked for ages and shared stories. Was really nice. She's extremely talented and very driven.

Then, on one of my better days, held it together long enough to attend an interview with an organisation I'm really excited about. I'd been for an interview a couple of months back. It went really well, but then didn't hear anything, so thought maybe they didn't need me. Turns out the director just had something else to attend to. By the end of our second meeting, he made me an offer that was pretty amazing. Significantly more than I expected, and great working conditions. I'm not jumping around the room yet, because nothing is signed, but we're in the process of drawing up a contract. If it goes through, the extra income would be pretty life-changing for me.

Randomly, one of their associate partners also dropped me a line and I'm going to discuss a contract with them as well next week. 

As fate would have it, they're both working in trauma and mental health. Also got a strong emphasis on human rights, which appeals. 

So, that's really exciting and given me something to look forward to. Going to work hard on my health so that I'm able to take this on. If I can get these contracts signed by mid-November, that should also help smooth over my visa application as they're renowned organisations in the country.

Action plan for the next week:

1. Finish meds, take painkillers, return to doctor if they haven't worked.
2. Squeeze the life out of Harris when he arrives.
3. Go get me a couple of contracts and a healthy living.
4. Continue to look for Gizmo.

Right, back to bed.

Poster on Clinic Wall Warning About Ebola

Monday, 14 October 2019

Crash Course

Well, it's been a funny couple of weeks. First with malaria, then the news of an attack in Musanze. Went golden monkey trekking there with mum and Merrick on Monday 30th September, and night of Friday 4th October, FDLR rebels crossed the border from DRC killing eight residents in Kinigi and injuring 18. Volcanoes National Park has one mountain, Sabyinyo, which is shared between Rwanda, Uganda and DRC. Security is usually extremely tight in the region, and you go primate trekking with an armed guard, so it was quite disturbing news that an attack had been carried out so close to the main tourism centre. Rwandan forces retaliated, reportedly killing 19 rebels

Hopefully a one-off event. There were some bus attacks at the end of last year on the border with Burundi, with FDLR rebels reportedly taking refuge in Nyungwe Forest. Apparently, they have since been cleared, and Rwanda tourism board issued a notice soon after reassuring people that it was safe to visit the park. 

Despite all this, travelling in Rwanda still feels extremely safe, although I prefer to take private transport long-distance rather than buses. Mostly because it's much more comfortable, but also because I usually travel north to Gisenyi and there were health concerns with the Ebola breakout (which has since been brought under control) and then passing through Musanze there's just a sense, rightly or wrongly, that you're a bit safer, or at least a bit more autonomously mobile, in a private vehicle.

That said... this week proved me wrong on one of those counts.

Poor Gizmo has a bad leg injury. He has an infected cut and was getting really feisty with me when I tried to help him. I wanted to go to Gisenyi for a few days, and as he wouldn't let anyone near him to treat him, I decided to drop him off with Dr. Arum so that he could heal properly whilst I'm away.

My brave little boy.

To solve some of my transport woes, I set up a group called Rwanda Carpool. There's a big problem with hiring cars in Rwanda. You can usually only hire a car from Kigali. There are no car hire depots in any of the other major cities, like Gisenyi, Cyangugu, Musanze or Butare. I only need to hire a car to get from Kigali to Gisenyi, then one to get back again when I'm ready - so, two days' hire. But because there isn't a depot in Gisenyi, I have to pay for all the days I'm there, even if I'm not using the car. That gets stupid expensive real fast. 

The idea with the carpool was to try to reduce some of this expense by allowing people to offer a ride if they're going in the same direction. Seventy people signed up within the first hour!

For my trip to Gisenyi this time, I found someone who wanted to share a taxi. This brought the price down from FRW 70,000 (about $75/£60) to 35,000 each ($37.50/£30), a significant improvement. That's the same as it would cost to hire a car for the day, before petrol.

The driver came to pick me up at 8:30 a.m. so that I could drop Gizmo at the vet and then go pick up my roadie. We were just entering a large roundabout near Sonatubes, about 10 minutes from the veterinary clinic, when my driver decides to cut straight in front of a giant cement lorry! I saw it happening in slow motion and could hardly believe what I was seeing. We were on the outside lane, for turning right, when we wanted to be on the inside to go straight over. Roundabouts are a fairly new concept here and lane discipline is non-existent. 

The lorry was already on our inside. The sensible thing would have been to turn right, go down the road, turn around and come back to try again. Instead, my driver glanced to the left, must have seen the lorry (it was MASSIVE), then pulled straight across it. The lorry obviously hit us, the grill about a foot from my face, and proceeded to push us sideways around the roundabout until our taxi got free and pivoted into oncoming traffic. 

I screamed for my life. 

I was literally face-to-face with the grill of the lorry and fairly convinced it would drive right over us. Thankfully we were travelling at about two miles per hour and no real harm was done. 

Within minutes we were on the side of the roundabout with the lorry in front. There were about five police officers and twenty spectators - not one of whom came to ask if I was all right. I just sat there in total shock, wondering what to do.
The lorry that hit us.


All things considered, we got away really lightly, and lovely little Gizmo kept his cool throughout the whole thing. My fabulous friend, Emmy, had his taxi not far away and he came to collect me. Took us to the vet's, where Thomas, my carpool accomplice, came to meet us. It was a bit of a weird text message: 'Sorry I'm late. Just been hit by a lorry. Need to find a better driver...'

Also ironic, almost getting squished by a lorry after I've been working so hard to get well again from malaria. Dad sent a smoothie maker out for me, and I've been packing it with bananas, tree tomatoes, Chinese lanterns, passion fruit, mango juice and frozen pineapple chunks. A smoothie a day to get all my vitamins and minerals, and easier to cope with than solid food.

Moringa leaf powder and seeds.

Also tried putting in a teaspoon of this moringa powder, which they were selling super cheap at the local petrol station. I was curious and decided to give it a go, as it's supposed to be very good for you. Turns out I'm allergic. Burning sensation, asthma agro. Oh well. Gave it away. 

By midweek I was feeling a thousand times better and dragged myself to the European Business Association Meeting at CasaKeza, where we learned all about the new property tax laws, though I'm still not at all sure how they apply to my business - if at all. But there was a bonfire and free paella. Nice chance to catch up with friends.

Healthy, non-malarial Marion.
Free Paella
After dropping Gizmo at the vet, me and Thomas climbed aboard Emmy's ride and headed north for Gisenyi. Sameer is leaving for a month on 20th and I wanted to spend some time with him before he goes. When we were just friends, we'd go weeks without seeing each other, now we try to see each other as much as possible, and a whole month without him is a daunting prospect. Thankfully, Harris arrives back on 28th, and possibly Ian, so I'm not going to be short of friends to hang out with. 

Since arriving in Gisenyi, it's been raining almost non-stop. Seriously yucky weather. But yesterday there was a break in the clouds and a little sunshine appeared. We headed into town for food and relaxation. 

Hanging out at One Degree South
Pilipili Sauce
Then we headed over to Serena to sit by their beach and enjoy a traditional helping of apple pie and ice cream. Although Ebola is now under control in Goma, precautions are still being taken, as this poster near the border shows. As well as putting your bags through the security scanner at Serena, you also now have to wash your hands at a custom-made washing station just outside the door. I guess they get a lot of health staff and NGO types staying from DRC.

Still, it is a lovely beach, and it's a couple of degrees warmer in Gisenyi than at the tea garden, so we went for a paddle and enjoyed the afternoon rays.

(panoramic, click to enlarge)


Just enjoying our last few days together, then he flies off home for a bit and I need to apply for my visa renewal. All a bit up in the air right now. Not sure what's likely to happen. All you can do is apply and see. Enjoy the sunshine whilst it lasts.